Getting Obesity on the Public Policy Agenda at the State Level NACCHO-ASTHO Meeting July 14, 2005...
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Transcript of Getting Obesity on the Public Policy Agenda at the State Level NACCHO-ASTHO Meeting July 14, 2005...
Getting Obesity on the Public Policy Agenda at the State Level
NACCHO-ASTHO Meeting • July 14, 2005
Getting Obesity on the Public Policy Agenda at the State Level
NACCHO-ASTHO Meeting • July 14, 2005
Robert F. St. Peter, M.D.
Kansas Health Institute
Intended AudiencesIntended Audiences
LegislatureGovernorPublic health (local and state)SchoolsPrivate sectorPhilanthropies
Public OpinionPublic Opinion Americans recognize problem is increasing Understand link to health problems Ambivalent about role of government
Favorable towards awareness and education Oppose junk food taxes, intrusion on individual
freedoms Some exception for childhood obesity
Healthier school lunches More physical education/activity Health education
Approach to Obesity as a Public Policy Issue
Approach to Obesity as a Public Policy Issue
Get attention of policy makersFrame it as a public policy issueCreate framework for policy
interventionsPresent options from other statesIdentify local preferences
Approach to Obesity as a Public Policy Issue
Approach to Obesity as a Public Policy Issue
Get attention of policy makersFrame it as a public policy issueCreate framework for policy
interventionsPresent options from other statesIdentify local preferences
Raising the ProfileRaising the Profile
Series of forums and brownbag discussions
Data collection in schoolsStatewide survey with emphasis
on minority populationsVisits by key CDC personnelIOM regional conference in July
Approach to Obesity as a Public Policy Issue
Approach to Obesity as a Public Policy Issue
Get attention of policy makersFrame it as a public policy issueCreate framework for policy
interventionsPresent options from other statesIdentify local preferences
Obesity as Public PolicyObesity as Public Policy
Health care costsUnique role of schoolsPotential for bias &
discriminationDisparities among racial and
ethnic minorities
Health Care Costs of ObesityHealth Care Costs of Obesity 6% of adult health care expenditures Expenditures 36% higher for obese v. non-obese Projections of 1 out of 4 health care dollars by
2020 $657 million annual expenditures-KS
$138m for Medicare $143m for Medicaid
Cost to business $13 billion annually-US $8b in direct health care costs $2.4b in sick leave $1.8b for life insurance $1b disability insurance
Cost shift to non-obese
Kansas US
Total pop. 19.6% 20.0%
Medicare pop. 19.8% 20.7%
Medicaid pop. 28.4% 29.6%
Adult Obesity Prevalence (BMI ≥30), 1998-2000
Source: Finkelstein, Fiebelkorn and Wang, 2004
Unique Role of SchoolsUnique Role of Schools Reaches young people and has preventive
advantage Link between learning and health Nutrition education
4 hours/yr in middle school (median, US) 5 hours/yr in high school
Physical education Declining participation in daily physical activity
School food environments USDA food programs Competitive food availability Vending contracts
Affects Disparities Among Racial and Ethnic MinoritiesAffects Disparities Among
Racial and Ethnic Minorities
Approach to Obesity as a Public Policy Issue
Approach to Obesity as a Public Policy Issue
Get attention of policy makersFrame it as a public policy issueCreate framework for policy
interventionsPresent options from other statesIdentify local preferences
Providing a FrameworkProviding a Framework
Call to Action to Prevent and Decrease Overweight and Obesity (Satcher, DHHS 2001) Promote recognition Assist balancing healthful eating with
regular physical activity Effective, culturally appropriate
interventions Encourage environmental change Engage public-private partnerships
Providing a Framework (cont.)Providing a Framework (cont.)
Policy suggestions and actions Schools and youth-serving organizations Work sites and employer programs Community support programs, services
and policies Community design for healthy eating
and active living Food industry and food marketing Health care system Communication and public advocacy
Source Raymond and Moon, 2003
Approach to Obesity as a Public Policy Issue
Approach to Obesity as a Public Policy Issue
Get attention of policy makersFrame it as a public policy issueCreate framework for policy
interventionsPresent options from other statesIdentify local preferences
Analysis of Legislative Approaches in StatesAnalysis of Legislative Approaches in States
KHI assessed state legislation between 1999 and 2003
Identified 79 initiatives30 statesUp-tick after 2001 SG report
Types of Legislative InitiativesTypes of Legislative Initiatives
Commemorative/advisory resolutions Advisory commission/studies Insurance regulation School food programs Nutrition education Physical education/activity for children Adult physical activity Other
2005 Kansas Legislature2005 Kansas Legislature
Bills enacted: SB 154 creates guidelines on nutritional
standards, physical activity and wellness education
SCR 1604 requires Kansas Department of Education to study policies on school nutrition and physical activity and report to the 2006 legislature
2005 Kansas Legislature (cont.)2005 Kansas Legislature (cont.)
Bills that did not become law: HB 2137 regulated offerings in school
vending machines HB 2208 created a 13 member task
force to study obesity and at-risk populations and develop state plan
HB 2417 created a 30 member council that would recommend a comprehensive state plan to increase prevention and management of obesity
Kansas School Nutrition and Physical Activities Policies Study
Kansas School Nutrition and Physical Activities Policies Study Response to SCR 1604 Funding from conversion foundation for
analysis No new funding to Dept of Ed for programs Data collected at district and school level Will address topics of:
1. Nutrition2. Nutrition education3. Physical education4. Physical activity5. Health education
Kansas School Nutrition and Physical Activities Policies Study
Kansas School Nutrition and Physical Activities Policies Study
NUTRITION
Open campus Lunchroom policies A la carte options Food and beverage
vending Financial issues
impacting sustainability of reimbursable food program
PHYS. ACTIVITY AND EDUCATION
Curriculum Staff adequacy and
training School day structure
related to accommodating PA/PE
Frequency and duration